Provider Demographics
NPI:1821647686
Name:THOMAS, DONTREASE MONIQUE (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:DONTREASE
Middle Name:MONIQUE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 OLDENWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-9774
Mailing Address - Country:US
Mailing Address - Phone:773-350-3710
Mailing Address - Fax:704-782-7617
Practice Address - Street 1:523 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7771
Practice Address - Country:US
Practice Address - Phone:704-939-1100
Practice Address - Fax:704-939-1173
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2025-05-22
Deactivation Date:2024-08-14
Deactivation Code:
Reactivation Date:2024-08-20
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NC14893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251S00000XAgenciesCommunity/Behavioral Health